Individual
DR. MARC S MASTROPAOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
IHA HOSPITAL MEDICINE SERVICES, 5301 MCAULEY DRIVE, YPSILANTI, MI 48197
(734) 712-8676
(248) 476-6465
Mailing address
24 FRANK LLOYD WRIGHT DRIVE, SUITE J2000, ANN ARBOR, MI 48105
(734) 747-6766
(248) 476-6465
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101009644
MI
207R00000X
Internal Medicine Physician
MM009644
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1156311905
BCBS
MI
01
—
124168
CARE CHOICES/PREF CHOICES
MI
01
—
421561900
TAX ID
MI
05
—
4691605
—
MI
Enumeration date
04/10/2006
Last updated
09/13/2023
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